Just Another Teachin’ Tuesday: Rufinamide – Another Profit Producing Pipedream?

There seems to be a never ending stream of speculation as to whether any number of drugs will provide relief for what we endure. Unfortunately, the speculation isn’t grounded in anything new and exciting in terms of cause. Rather, it’s about playing pin the tail on the donkey with off-label applications of existing drugs.

Allow me to make a clarification before moving on. I am not anti-meds. Do I think they’re over-prescribed? Yes. But do I think they’re, in many cases, a necessity for the very preservation of life? Yes. Okay, that’s settled.

The latest bit of drug-folly involves rufinamide, an anticonvulsant used primarily in the treatment of Lennox-Gastaut syndrome – an icky form of childhood-onset epilepsy; often accompanied by mental retardation, psychological problems, and behavior issues.

As you may know, anticonvulsants are prescribed in buckets for the treatment of bipolarity. For that matter, the benzodiazepines (Xanax, Ativan, Valium, etc.)  are anticonvulsants. From what I’ve read, rufinamide is closely related to the anticonvulsant, carbamazepine (Tegretol).

Given its pedigree it isn’t surprising rufinamide would work well for bipolarity. But a new hypothesis (as in big-time supposition) is it’s effective in the treatment of depression, generalized anxiety, panic, OCD, eating disorders, and assorted substance abuse issues. Rufinamide’s efficacy is based in its impact upon the modulation of the activity of sodium channels. But before you get too excited, understand the aforementioned hypothesis is based upon two case studies.

One of these involved a woman with a primary diagnosis of bipolar disorder; along with panic, OCD, and an eating disorder. The second case involved a woman who was also enduring bipolar disorder; as well as alcohol abuse and chronic pain. Both had no luck with numerous treatment approaches; one  including electroconvulsive therapy (ECT).

By the way, speaking of ECT  – isn’t it odd that generating convulsions may provide relief for certain mood issues, and anticonvulsant meds provide relief, as well?  Hmmm.

No doubt, the rufinamide biz is interesting; and I’m happy to know treatment alternatives for the mood and anxiety disorders are being explored – though I wish it wasn’t always for treatment-resistant situations. And, of course, I wish this was about brand new meds designed for brand new discoveries of cause.

But I gotta’ tell ya’ – when off-label applications of existing drugs are being touted as – well – potential breakthroughs, I get the feeling big-pharma is somehow involved. And the drums are beating loudly in an effort to create new markets for old drugs – which, of course, equates to big bucks. Does that make me a cynic?

So what do you think, chipur readers? Is this just more irresponsible drug peddling for purposes of profit?